Oceanside Dolphins Club Membership Application and Registration
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Email *
ATHLETE INFORMATION
Last Name
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First Name
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Date of Birth
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/
DD
/
YYYY
Age Division *
Gender Division *
Email
 *
Address (City, State, Zip)
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AAU Number OR USATF Number
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T-Shirt Size
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Captionless Image
Athlete Competing Events *
Required
PARENT OR GUARDIAN INFORMATION
Parent/Guardian 1 First and Last Name
 *
Parent/Guardian 1 Phone Number
 *
Parent/Guardian 1 Email
 *
PARENT OR GUARDIAN 2 INFORMATION
Parent/Guardian 2 First and Last Name
Parent/Guardian 2 Phone Number
Parent/Guardian 2 Email
CONDITIONS OF PARTICIPATION
THE ATHLETE/APPLICANT AND PARENT/GUARDIAN AGREE TO:

1. Conduct myself in a thoughtful, respectful manner at all times and refrain from all offensive language.

2. Treat all club, facilities, schools, and venue property with care and respect.

3. Abide by all of the rules, directions, and decisions of coaches and officials.

4. Participate fully and support all team activities to the best of *
Required
PARTICIPANT RELEASE OF LIABILITY WAIVER AND HOLD HARMLESS OF RELEASE LIABILITY
In consideration of being allowed to participate in the program, related events and activities, and use of equipment, I the undersigned, acknowledge, appreciate, and agree that:

1. I knowingly and freely assume all risks, both known and unknown, even if arising from the negligence of the releases or others, and assume full responsibility for my participation.

2. I willingly agree to comply with the terms and conditions for participation. If I observe any unusual significant hazard during my presence or participation, I will remove myself from participation and bring such to the attention of the nearest official immediately.

3. I, for myself and on behalf of my family hereby release, indemnify, and hold harmless Roberto Suarez, Julie Ralph, additional and all coaching staff, team members, Oceanside Dolphins Running Club, Oceanside Parks and Recreation, The City of Oceanside, The City of Vista, Oceanside Unified School District, Vista Unified School District, and all affiliated members from any claims, demands, losses, and liability arising out of or related to any injury or disability I may suffer, or loss or damage to person or property. *
Required
HEALTH STATEMENT
By signing below, I am consenting my child or myself to be healthy and fit and able to participate in the running club activities. I will notify Roberto Suarez or Julie Ralph if they or I suffer from any medical or health condition that may cause injury to themselves, myself, or others, or may require emergency care during my participation. *
Required
MEDIA STATEMENT
By signing below, I hereby grant Roberto Suarez, Julie Ralph, and Oceanside Dolphins rights to use my picture, voice, or statements including any images and video made by Roberto Suarez/Julie Ralph/ Oceanside Dolphins Running Club. *
Required
CONSENT FOR MEDICAL TREATMENT
I hereby permit all medical attention to be administered to my athlete(s) in the event of an accident, injury, sickness, etc., under the direction of the program’s staff listed below, until I may be contacted. I agree to assume sole responsibility for payment of any medical, dental, or other expenses incurred as a result of such sickness or injury. In my absence, or if I cannot be contacted, the coaching staff is designated to act on my behalf. I hereby consent to emergency medical care prescribed by a licensed Doctor of Medicine or Doctor
of Dentistry. This care may be given under whatever conditions are necessary to preserve the life, limb, or well being of my dependent minor. *
Required
I will be sending payment through:
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PAYMENT PLAN
Will you require a payment plan?
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MEDICAL RELEASE FORM

Medical Release From will also be available on the team "Master Index" document.

FINAL SUBMISSION
By digitally signing below and digitally submitting this form you understand and agree to all of our above terms and conditions. You understand that you still will have to submit the Medical Release Form and Club Payments to complete the full registration.
Parent/Guardian Signature
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